Effectiveness Of Public Stroke Education On Symptom Recognition And Response Among Adults Below 65 Years Old: A Systematic Review

Abstract

Aims: This review aims to investigate the effectiveness of public health campaigns on improving stroke symptom recognition and intention to call emergency medical services (EMS) among adults below 65 years old. Background: Stroke is the second leading cause of death worldwide and prognosis is often preventable. Recent studies have shown that there is an alarming increase in younger people getting stroke. Public campaigns are often used to improve stroke symptom recognition and intention to call EMS. Although younger patients have a better chance at recovery, few studies have evaluated the effectiveness of these campaigns on adults below 65 years old. Method and design: Seven databases, including Cochrane Library, CINAHL, Embase, Medline, PsycINFO, Scopus, and ProQuest Dissertations and Theses, were searched from inception till 24 January 2021. A meta-analysis was conducted to synthesis the effects of the public stroke education campaigns on stroke symptom recognition and intention to call EMS among adults below 65 years old. A narrative synthesis approach was used to analyse what education content and campaign design were best suited for the demographic. Results: Thirteen studies from 2001 to 2019 were included. The estimated pooled RR for post-campaign compared with pre-campaign on stroke symptom recognition and intention to call EMS was 1.20 (95% CI: 1.07-1.36, p=0.002) and 1.19 (95% CI: 1.11-1.28, p<0.00001), respectively. Evident trends were observed in terms of educational content and campaign design for adults below 65 years old. Conclusion: Public stroke education campaigns were found to have significant impact on stroke symptom recognition and intention to call EMS. Additionally, usage of FAST acronym in platforms such as broadcast and digital media was found to be effective. The evidence generated from this review could be applied to inform future campaigns targeted at adults below 65 years old.